Key takeaways
- Medicaid is free or near-free coverage — eligibility expanded in most states, and you can apply any time of year.
- Marketplace plans at HealthCare.gov come with income-based subsidies that shrink premiums dramatically for lower incomes.
- Nonprofit hospitals are legally required to have charity care (financial assistance) policies — ask before paying any large bill.
Table of contents
Medicaid & CHIP
Medicaid covers low-income adults and children with little or no cost, and CHIP covers kids in families earning too much for Medicaid but too little for private coverage. Income limits track the Federal Poverty Level and vary by state — check where your household falls with our FPL calculator, then apply through Medicaid.gov or your state agency. Enrollment is year-round, and qualifying for Medicaid often auto-qualifies you for other programs like SNAP and Lifeline.
Marketplace coverage and subsidies
If you don't qualify for Medicaid, HealthCare.gov plans come with premium tax credits that scale with income — many households pay far less than sticker price, some close to nothing. Open enrollment runs each fall, but job loss, moving, or losing other coverage opens a special enrollment period any time. Free local helpers ("navigators") can walk you through plan choice at no cost.
Care without insurance
Federally funded community health centers charge on a sliding scale based on income — find one at HRSA's locator. Nonprofit hospitals must offer financial assistance (charity care) under federal law: ask for the policy in writing before paying any large bill, because qualifying can erase or slash it — even retroactively. For prescriptions, manufacturer assistance programs and discount programs routinely beat cash prices.
Medical debt
Never pay a large medical bill without three steps: request an itemized bill (errors are rampant), apply for charity care, and negotiate — self-pay discounts and interest-free payment plans are standard when asked. Medical debt now has special credit protections: paid medical collections come off reports, and unpaid ones get a waiting period. If bills have spiraled, our debt relief guide and hardship triage cover the honest options.
Frequently asked questions
Can I get health coverage if I have no income?
Yes — in most states, adults with little or no income qualify for Medicaid, free or nearly free, with year-round enrollment.
What is hospital charity care?
Financial assistance nonprofit hospitals are federally required to offer — based on income, it can reduce or eliminate a bill, sometimes even after you've been billed. You usually have to ask.
Does medical debt hurt my credit score?
Less than it used to: paid medical collections are removed from credit reports, small ones are excluded, and unpaid ones face a waiting period before reporting. It can still hurt eventually — charity care and payment plans first.
Estimates are informational only, not financial advice or an offer of credit — see our disclaimers.